JMIR Publications

ABSTRACT

Background:

Mental health and substance use disorders are the main causes of disability among adolescents and young adults, yet fewer than half experiencing these problems seek professional help. Young people frequently search online for health information and services suggesting that online modalities might promote help-seeking among young people who need it. To support young people in their help-seeking, we developed an online mental health service navigation website called Link. Link is based on the Theory of Planned Behaviour and connects young people with treatment based on the type and severity of mental health symptoms they report.

Objective:

The primary objective was to investigate the effect of Link on young people’s positive affect compared to usual help-seeking strategies immediately post-intervention. Secondary objectives included testing the effect of Link on negative affect, psychological distress, barriers to help-seeking, and help-seeking intentions.

Methods:

Young people, aged between 18 and 25 years, were recruited online from an open access website to participate in a randomised controlled trial. Participants were stratified by gender and psychological distress into either the intervention arm (Link) or control arm (usual help-seeking strategies). Baseline, immediate post-intervention, one-month and three-month surveys were all self-report and administered online. Measures included the Positive and Negative Affect Schedule (PANAS), Kessler Psychological Distress Scale (K10), Barriers to Adolescent Help-Seeking scale (BASH), and the General Help-Seeking Questionnaire (GHSQ).

Results:

431 young people were recruited into the trial (intervention n = 205; control n = 208) and 78% of those randomised to the intervention arm visited the Link website. There was no evidence to support a difference between the intervention and control arms on the primary outcome, with positive affect increasing by approximately 30% between baseline and three months equally in both arms. Negative affect decreased for the intervention arm compared to the control arm with a difference of 1.4 (95% CI 0.2 to 2.5) points immediately after the intervention and 2.6 (95% CI 1.1 to 4.1) at one-month. K10 scores were unchanged and remained high in both arms. No changes were found on the BASH or GHSQ, however participants in the intervention arm appeared more satisfied with their help-seeking process and outcomes at one and three months post-intervention.

Conclusions:

The process of prompting young people to seek mental health information and services appears to improve affective state and increase help-seeking intentions among young people, regardless of whether they use an online dedicated youth-focused tool such as Link or their usual search strategies. However, young people report greater satisfaction using tools designed specifically for them which may encourage future help-seeking. The ability of online tools to match mental health need with appropriate care should be explored further. Clinical Trial: The trial was registered with the Australian New Zealand Clinical Trials Registry on 20th November 2014 (Ref #: ACTRN126140012223628).